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    "The robot is not, in my opinion, a skip."

    August 30th, 2023
    @mattbeane via Twitter on Aug 30, 2023

    I came across this in my dissertation today. It stopped me in my tracks.

    Most studies show robotic surgery gets equivalent outcomes to traditional surgery. You read data like this and you wonder about how much skill remains under the hood in the profession…

    The word 'skip' is highlighted in the sentence: The robot is not, in my opinion, a skip. The full paragraph of text: It's not the same as doing a weekend course with intuitive surgical and then saying you're a robotic surgeon and now offering it at your hospital [italics indicate heavy emphasis]. I did 300 and something cases a as a fellow on the robot and 300 and something cases laparoscopically. So a huuuge difference in the level of skill set since I was operating four days a week as opposed to the guy who's offering robotic surgery of surgery and does it twice a month, okay? The way I was trained, and the way I train my residents, my fellows and the people I train at the national level is that you need to know how to do a procedure laparoscopically first before you'd tackle it robotically. The robot is not, in my opinion, a skip. You don't jump from open to robot, although that is exactly what has happened in the last five years. For the vast majority, and it's a marketing, money issue driven by Intuitive. No concern for patient care. And unfortunately, the surgeons who don't have the laparoscopic training who have been working for 10 to 15 years - panic, because they're like "I can't do minimally invasive surgery, maybe I can do it with the robot." Right? And then that'll help with marketing and it's a money thing, so you're no longer thinking about patient care it's now driven by money from Intuitive's. perspective and from the practice perspective. This is all a mistake. This is a huge fucking mistake. - AP


    Beane, M. (2017). Operating in the shadows: The productive deviance needed to make robotic surgery work [PhD thesis, MIT]. http://hdl.handle.net/1721.1/113956